摘要
目的探讨老年冠状动脉慢性完全闭塞(CTO)患者经皮冠状动脉介入(PCI)治疗的效果及预后。方法选取2018年1—12月于郑州大学第一附属医院心内科就诊经冠脉造影检查证实为CTO的270例老年(年龄≥65岁)患者,其中成功行PCI且给予最佳药物治疗(OMT)的联合治疗组(PCI组)140例,剩余130例患者接受最佳药物治疗,纳入对照组(OMT组)。分析比较两组患者治疗前、治疗12个月后的心脏彩超指标、症状改善情况、N末端脑钠肽前体(NT-proBNP)水平及主要心血管不良事件(MACE)发生情况等。结果两组患者术前基线资料比较,差异无统计学意义(P>0.05)。经过临床干预治疗后两组患者均取得一定疗效,其中PCI组患者治疗12个月后症状改善率高于OMT组,差异有统计学意义(P<0.05);治疗12个月后PCI组患者心功能指标较OMT组改善,MACE累积发生率更低,差异均有统计学意义(P<0.05)。结论老年冠脉慢性完全闭塞患者接受经皮冠状动脉介入治疗有获益,在药物治疗的基础上联合PCI治疗可以更好地改善患者心功能和临床症状,减少再住院率和主要心血管不良事件的发生率,提高患者生活质量,改善短期预后。
Objective To investigate the effects and prognosis of percutaneous coronary intervention(PCI)in elderly patients with chronic total coronary occlusion(CTO).Methods A total of 270 elderly patients(age≥65 years old)who were diagnosed with CTO confirmed by coronary angiography in the Department of Cardiology of the First Affiliated Hospital of Zhengzhou University from January 2018 to December 2018 were selected.Among them,140 patients in the combined treatment group(PCI group)that successfully treated by PCI and were given optimal medical therapy,and the remaining 130 patients were treated by optimal medical therapy and included in the control group(OMT group).The ultrasound cardiogram index,symptom improvement,N-terminal pro-B-type natriuretic peptide(NT-proBNP)level and the major adverse cardiovascular events(MACE)were analyzed and compared between the two groups at baseline and 12 months after treatment.Results The baseline data of two groups were compared and there was no statistically significant difference(P>0.05).After clinical intervention and treatment,both groups of patients achieved certain therapeutic effects.After 12 months of treatment,the symptom improvement rate of PCI group was higher than that of OMT group,and the difference was statistically significant(P<0.05).After 12 months of treatment,the cardiac function indexes of the PCI group were significantly improved compared with the OMT group,the cumulative incidence of MACE was lower than the OMT group,and the differences were statistically significant(P<0.05).Conclusion Elderly patients with chronic total coronary occlusion can benefit from percutaneous coronary intervention.Combining PCI therapy on the basis of optimal medical therapy can better improve the patients’cardiac function and clinical symptoms,reduce the rate of rehospitalization and major adverse cardiovascular events,improve the quality of life and short-term prognosis of patients.
作者
刘雪蒙
吴磊明
杜彬彬
李鹏程
张彦周
LIU Xuemeng;WU Leiming;DU Binbin;LI Pengcheng;ZHANG Yanzhou(Department of Cardiology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)
出处
《河南医学研究》
CAS
2021年第8期1391-1395,共5页
Henan Medical Research
